What Is Pelvic Inflammatory Disease?by Robin Elise Weiss, Ph.D. Health Professional
Pelvic inflammatory disease (PID) is a disease of the female reproductive organs. It is caused when bacteria move from the cervix and vagina up into the uterus, ovaries, and fallopian tubes. This is commonly caused by gonorrhea and/or chlamydia, which are both sexually transmitted infections (STIs). However, it can also be caused by trichomoniasis (another STI) or bacterial vaginosis. Every year there are more than a million cases diagnosed in the United States.
What are the symptoms of pelvic inflammatory disease?
Many women describe the symptoms of PID as vague, and it may even be hard to tell that the problem is based in in the pelvis. You may mistake the symptoms of PID for something else entirely, which makes it particularly difficult to spot and treat. It only takes a few weeks of having untreated gonorrhea or chlamydia before it may turn into PID. This is one reason why getting tested and treated regularly for STIs is important.
You should also report symptoms that may not seem like a big deal to your doctor to get further evaluation. You might have symptoms that seem flu-like: nausea and vomiting, fever, and chills. You might feel like you simply have cramps with pain in the lower abdominal area. There are also some symptoms that should always be reported, even if you think you know what is causing them, including:
Pain when you urinate
Pain when you have sex
Abnormal discharge from your vagina
Abnormal menstrual bleeding or cycle
While these could certainly be signs complications or problems other than PID, they should still always be reported to your doctor.
How is pelvic inflammatory disease diagnosed?
The diagnosis of PID is always handled by a medical professional. A pelvic exam is the first step. You may need lab tests, an ultrasound, or, in extreme cases, surgery. The sooner you get in to see someone, the easier it is to fix the problem.
How do you treatment pelvic inflammatory disease?
One of the biggest risks of PID is that you don’t get treated soon enough and develop scarring in your reproductive tract. This can lead to more complicated pregnancies or even infertility. The good news is that treatment for PID is typically just antibiotic therapy. Many of these antibiotics are given via an oral medication, but some cases may need IV antibiotics. If you are already pregnant, have HIV, have a severe case of PID, or have an abscess, you may need to be treated in the hospital. An abscess may require surgery to help resolve the problem.
You may see your symptoms disappear before you have finished taking your medication. But you should finish the medication as prescribed, even if you are feeling better. Not doing so is a common mistake among those being treated. Your doctor may want to follow up with you in two or three days to ensure that your symptoms are getting better. Sometimes you need a change in medication.
One thing to talk to your doctor about is whether your sexual partner(s) need treatment. This is particularly important if you have gonorrhea or chlamydia.
What are the risks of pelvic inflammatory disease?
The biggest long-term risk of PID is infertility. About one in eight women who have a history of PID also have trouble getting pregnant.
When PID is left untreated, scars can form inside the reproductive tract. This scarring is one of the main reasons for an increase in infertility after PID. Even after the active infection is gone, this scarring can cause pregnancy complications. One of the most common of these problems is an ectopic pregnancy (a pregnancy that is outside of the uterus). Lastly, long-term pain from the scarring is also possible.
There has been some talk of an increase in the rate of PID in women who use an intrauterine device (IUD). However, after the initial three weeks of having an IUD placed, only about 1 percent of IUD users had PID, including users who tested positive for gonorrhea and/or chlamydia and those who tested negative before the IUD was inserted.
Can you prevent pelvic inflammatory disease?
Because PID is a disease that is associated with sexual activity, it is important to note that certain sexual practices contribute to the risk. The only way to drastically reduce your risk of PID is to abstain from vaginal, anal, or oral intercourse — which is an unacceptable standard for most people. Therefore, you should work to minimize your risks. You can minimize your risks by using a condom every time you have sex, even if you are using something else to prevent pregnancy. It's also wise to make sure your partners are tested for STIs prior to having sex and minimizing your number of partners. Your risk is lowest in a relationship where you are both monogamous.
It is important to note that women younger than 25 are most at risk of PID, though it is possible to get it after menopause too. There are other practices that can contribute to an increased risk of PID as well. For example, douching may lead to a higher rate of PID. You are also more likely to get PID if you have had PID before.
The bottom line is that if you think you have any odd symptoms, see a medical professional quickly. The sooner you are seen, the more likely it is that treatment will be simple with minimal long-term damage to your reproductive organs. If you are at risk, talk to your practitioner about being screened at regular intervals.
Pelvic Inflammatory Disease (PID). American College of Obstetricians and Gynecologists. September 2015.